目的 觀察替雷利珠單抗聯(lián)合吡柔比星治療肌層浸潤性膀胱癌的臨床療效。方法 選自復(fù)旦大學附屬中山醫(yī)院青浦分院2021年5月—2024年5月收治的肌層浸潤性膀胱癌患者90例進行回顧性研究，根據(jù)治療方案的不同分為對照組和治療組，每組各45例。對照組患者膀胱灌注注射用鹽酸吡柔比星，30 mg溶解在50 mL 5%葡萄糖注射液中，1次/周，連續(xù)治療9周。治療組在對照組基礎(chǔ)上靜脈輸注替雷利珠單抗注射液，第1次200 mg在60 min內(nèi)輸注完，患者耐受良好之后改為30 min內(nèi)輸注完，3周為1個療程，治療3個療程。觀察兩組患者臨床療效，比較治療前后兩組患者T淋巴細胞免疫功能，腫瘤標志物癌胚抗原（CEA）、糖類抗原125（CA-125）、細胞角蛋白19片段抗原21-1（CY-211）和神經(jīng)元特異性烯醇化酶（NSE）水平，及血清細胞因子堿性成纖維細胞生長因子（bFGF）、表皮生長因子（VEGF）及腫瘤壞死因子-α（TNF-α）水平。結(jié)果 治療后，治療組客觀緩解率明顯高于對照組（82.22% vs 62.22%，P＜0.05）。治療后，兩組CD4^＋/CD8^＋、CD3^＋、自然殺傷細胞（NK）水平顯著升高（P＜0.05）；且治療后，治療組CD4^＋/CD8^＋、CD3^＋、NK水平均明顯高于對照組（P＜0.05）。治療后，兩組患者CEA、CA-125、CY-211、NSE、bFGF、VEGF、TNF-α水平均明顯降低（P＜0.05），且治療后治療組這些血清因子水平均明顯低于對照組（P＜0.05）。結(jié)論 肌層浸潤性膀胱癌患者經(jīng)替雷利珠單抗聯(lián)合吡柔比星膀胱灌注治療效果更好，利于增強機體免疫功能，糾正異常血清細胞因子，降低腫瘤標志物水平，降低患者復(fù)發(fā)風險。

Objective To observe the clinical effect of tirelizumab combined with pirarubicin in treatment of muscular invasive bladder cancer. Methods The clinical data of patients (90 cases) with muscular invasive bladder cancer in Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University from May 2021 to May 2024 were analyzed retrospectively. They were randomly divided into control and treatment group based on different treatments, and each group had 45 cases. Patients in the control group were po administered with Pirarubicin Hydrochloride for injection to bladder for 9 weeks, 30 mg was dissolved in 50 mL of 5% glucose injection, once weekly. Patients in the treatment group were iv administered with Tislelizumab Injection on the basis of the control group, 200 mg was completed within 60 min for the first infusion, after the patient tolerated it well, the infusion was changed to 30 min. Three weeks was a course of treatment, and three courses of treatment were carried out. After treatment, the clinical evaluations were evaluated, and the T lymphocyte immune function, the levels of tumor markers CEA, CA-125, CY-211, and NSE, and the levels of serum bFGF, VEGF and TNF-α in two groups before and after treatment were compared. Results After treatment, the objective response rate in the treatment group was significantly higher than that in the control group (82.22% vs 62.22%, P < 0.05). After treatment, the levels of CD4⁺/CD8⁺, CD3⁺, and NK levels in both groups increased significantly (P < 0.05). After treatment, the levels of CD4⁺/CD8⁺, CD3⁺, and NK in treatment group were significantly higher than those in control group (P < 0.05). After treatment, the levels of CEA, CA-125, CY-211, NSE, bFGF, VEGF and TNF-α in both groups were significantly decreased (P < 0.05), and the levels of these serum factors in treatment group were significantly lower than those in control group after treatment (P < 0.05). Conclusion Intravesical infusion of terelizumab combined with pirarubicin in patients with muscular invasive bladder cancer has a better effect, which is conducive to enhancing the immune function, correcting abnormal serum cytokines, reducing tumor marker levels, and reducing the risk of recurrence.

R979.1

上海市青浦區(qū)衛(wèi)生健康委員會科研項目（QWJ2022-06）